Deutsche Rettungsflugwacht (DRF), the German air rescue organisation, is training its staff, including pilots, in techniques to support colleagues suffering stress from mission trauma.

Dr. Joerg Braun, medical director, says the DRF has established a comprehensive peer training system which 20 staff based at DRF air rescue centres have completed. "They will support their colleagues in dealing with disastrous events in their daily mission life," he adds. "The demand and the extent of the mission review can vary individually. Some individuals can do without any support. For others, interventions in order to cope with stressful experiences can be the right thing. Others might need more, maybe even professional support."

He explains that peers are staff trained to help their colleagues. "They are trained in psycho-social help and will show their colleagues ways and techniques such as structured dialogues how to deal with stressful missions. In this context they closely work with mental health professionals, who support them in their responsible tasks. In addition, a peer is a person that can be contacted during daily business who can communicate preventive stress management techniques, which serve to facilitate long-term stress management."

Pilots, paramedics and emergency physicians of the DRF's air rescue centres at Niebuell, Rendsburg, Bremen, Stuttgart, Freiburg and Zwickau have been trained in cooperation with the Institut Psycho Trauma Switzerland (IPTS) led by Dr. Gisela Perren-Klinger. The peers are also available to DRF's other rescue centres but the long-term goal is to have them based at all the centres.

The overall 40-hour peer training takes place in two stages. Trainees are taught how to recognise traumatic stress - what reactions can be considered normal and what might be pathological - and how to calm down colleagues showing signs of stress. "Techniques dealing with how to initiate and implement single and group debriefings are part of the training," Braun says. "In addition, the peers learn how to protect themselves from stress. Practical exercises enable the appropriate techniques to be learnt in realistic environments."

This training is followed by further courses focusing on communication and perception and the peers benefit through regular input from experienced professional specialists.

Braun points out: "In air rescue operations, crew members are confronted with extreme and possibly traumatic situations. In order to be able to pursue this demanding profession for many years and maintain a healthy outlook, it is necessary to talk about missions and about possibly critical incidents. Crew members have to learn to care for themselves and care for their colleagues; they should observe each other and learn their own ways how to deal with stress."

Joerg Baudach, who has recently taken charge of DRF aircraft operations, says that conversations with colleagues were cited prominently in surveys where rescue team members were asked about the most helpful experiences in dealing with the aftermath of after critical mission situations.

Baudach this summer took over from Winfried Beikler who joined the DRF in 1990 and became chief helicopter pilot and then deputy director of aircraft operations. In 1997 he took over as director of aircraft operations. Beikler will still be available as a consultant for the DRF.